DRUG TREATMENT OF GESTATIONAL HYPERTENSION; IMPLICATIONS FOR MATERNAL AND FETAL WELLBEING
Paul Otor Onah* and Idoko Chioma Catherine
ABSTRACT
Background: Hypertension in pregnancy carries high risk of adverse maternal and fetal outcomes. It is implicated in pre-eclampsia, proteinuria and eclampsia all of which carry high risk of maternal mortality. Gestational hypertension that is uncontrolled is often associated with low birth weight, intra-uterine growth retardation, still births and neonatal death. This study aims to assess antihypertensive utilization and their effect on maternal and fetal outcomes. Methods: This was a cohort observational study involving hypertensive women who received antenatal care in a tertiary hospital. Data was extracted from randomly selected medical records of eligible patients. The blood pressure, morbidity, drug(s), delivery method and fetal health data were used for analysis. Analysis: Data was analyzed using SPSS 21 for descriptive and inferential analysis. Pearson correlation test was used to assess relationship between antihypertensive drugs and maternal or fetal outcomes. Results: Maternal mortality and hypertensive complications remain relatively high, so also was prevalence of low birth weight and foetal deaths. A strong association was observed between aggressive blood pressure control and adverse foetal outcomes. Similar observation was noted for combination therapies involving diuretics. Discussion: The prescription of antihypertensives either contraindicated or of doubtful safety in pregnancy may potentially be contributing to adverse outcomes. There is need to emphasize the better management of hypertension in pregnancy to minimize the risk of adverse outcomes. Conclusion: There should be better use of drugs and improved blood pressure control among hypertensive pregnant women to improve maternal and fetal wellbeing.
Keywords: Pregnancy, Gestational hypertension, Drug therapy, fetal outcomes, maternal outcomes.
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